The all-inside technique for ACL reconstruction uses the semitendinous muscle tendon as a graft, and postoperative pain is slightly reduced. Through the full tibial tunnel technique, better anatomical graft placement is obtained with promising results, yet there are only few scientific articles comparing the two techniques. The main objective is evaluation of results after ACL reconstruction by comparing the clinical results of the two surgical techniques. A prospective study was conducted that included 63 eligible patients according to pre-established criteria. The technique used was randomly indicated to each patient. Demographics and clinical examination results were collected and subsequently stored. The assessment tools used were the International Knee Documentation Committee (IKDC), Knee injury and Osteoarthritis Outcome Score (KOOS) and the Visual Analogue Scale (VAS) with a 6-month follow-up period. The statistical analysis was performed for preoperative follow-up scores, at 3 and 6 months. All patients were operated by the same surgical team under spinal anesthesia with nerve block and tourniquet applied.In regards to IKDC and KOOS scores, the difference between the two interventions was not statistically significant (p = .579 and p = .710). Postoperative pain was slightly reduced in patients in the all-inside\ group but without any statistical significance compared to full-tibial tunnel technique(p = .259). There were no graft ruptures or late postoperative complications. Regarding IKDC, KOOS and VAS evaluating tools, there is no statistically significant difference between the two evaluated methods for ACL reconstruction, all-inside and full tibial tunnel at 3 months and 6 months after surgery.
Introduction: Bone marrow lesions (BMLs) are commonly described as magnetic resonance imaging (MRI) findings associated with stress injuries or trauma. The presence of BMLs closely correlates with pain and rapid joint deterioration. Case presentation: A 51-year-old healthy man presented to our clinic with severe knee pain due to BMLs. After 3 months of conservative treatment, arthroscopy and subchondroplasty (SCP) of the medial femoral condyle was performed. The IKDC (International Knee Documentation Committee) score improved from 39.9 to 66.7 at 6 months, and to 87.4 at 1 year after surgery. The KOOS (Knee Injury and Osteoarthritis Outcome) score improved from 38.5 to 77.7 at 6 months, and to 92.6 at 1 year after surgery. The Tegner Lysholm score improved from 23 to 80 at 6 months, and to 95 at 1 year after surgery. Conclusion: SCP may provide a viable approach to reduce pain associated with BML, with minimal risk of significant complications.
Ti6Al4V alloy is widely used for biomedical implants, and the modification of its surface, at nanoscale level, is a method to enhance its osseointegration. We modified the Ti6Al4V surface, with an initial micro rough topography, by using electrochemical anodization in 1M H3PO4 + 0.5 wt% HF electrolyte, and anodization potential of 20 V. By using short anodization duration, 5 min, or 15 min, the oxide layer presents a nanoporous morphology, and do not cover the entire surface. At an anodization time of 30 min, our results demonstrate the synthesis of continuous, highly ordered nanotubular TiO2 layer (diameter of nanotubes: 25-90 nm, thickness of the layer: 350-450 nm), superimposed over a micro rough topography, the oxide layer exhibiting a good adherence to the substrate, coherence and no brittleness. Anodization time of 2 hours provides the results very similar with those obtained at 30 min in terms of nanotubular layer topography, but some drawbacks appear in terms of surface coverage and continuity of the layer.
This paper treats the stability of two superposed gravitating streams rotating about the axis transverse to the horizontal magnetic field. The critical wave number for instability is found to be affected by rotation for propagation perpendicular to the axis about which the system rotates. The critical wave number for instability is not affected by rotation when waves propagate along the axis of rotation. The critical wave number is affected by both the magnetic field and the streaming velocity in both cases. Both the magnetic field and the rotation are stabilizing, while the streaming velocity is destabilizing.
Background: The objective of the arthroscopic treatment in tibial spine avulsion fractures (TSAF) is to achieve firm reduction and strong internal fixation while still having the patient undergo a minimally invasive procedure. Material and methods: The study was performed on 12 young patients with avulsion fracture of the anterior tibial spine. All 12 patients had type 3 Modified Meyers and McKeever fractures. The injury mechanism was direct anterior to posterior trauma in full leg length hyperextension with sport trauma reported in all cases. The physical examination revealed decreased range of motion, extension deficit, and pain during walking. Radiology, MRI, and CT pathologic findings described complete fracture of the anterior tibial spine with no clear signs of callus formation at the time of examination. All patients underwent arthroscopic suture surgical treatment. The Tegner, the Lysholm, and the International Knee Documentation Committee (IKDC) scores were used to evaluate subjective outcomes at three and six months after the surgery. Radiographs were used to assess callus formation and healing status of the fracture. Results: The mean IKDC score was 33.4 ± 23.3 (p = 0.032) preoperatively and 84.2 ± 14.3 at final follow-up (p = 0.0032, CI = 95%). The mean Tegner score improved from 3.8 ± 1.1 pre-operatively to 6.7 ± 2.2 at six months follow-up (p = 0.0231, CI = 95%). The Lysholm score differed significantly at baseline compared to final follow-up (53.7 ± 17.3 vs. 87.7 ± 9.9; p = 0.0066, CI = 95%). In all cases (n = 12), the radiographs taken after six months revealed the healing of the fracture in the anatomic position without secondary displacement. No functional knee instability was detected at the end of the study. Conclusions: The study provides preliminary promising results regarding fracture healing, knee stability, and functional subjective scores. Patient selection was a major factor of success prediction for this technique.
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